We live in exciting times where AI has emerged as a clear winner and therefore the past decade has seen advances we couldn’t phantom. What we also cannot ignore is the rise in number of cancers and new cancer drugs coming out of research everyday. Children(0-18 years of age) however were always considered a healthy population and its quite astonishing to see that the burden of childhood cancers is accelerating at a fast rate. The global burden of diagnosed cases every year is almost 400,000 and India alone accounts for approximately 70,000 cases an year. While India is still battling malnutrition, pneumonias and diarrhoeas in children with an alarming mortality and morbidity this comes as a huge hit.
Now a ticking worry is that ‘Have the Childhood cancers increased?’ OR ‘Are they getting diagnosed more because of better diagnostic tools available?’. Although there is insufficient data to support that food, preservatives, mobile radiations and other environmental factors can increase the risk of cancers in children. But it have been clearly proven that some infections like Hepatitis B Virus(HBV), Human Papilloma Virus (HPV) in childhood can lead to some adult cancers. Obesity and Diabetes in children leads to lifelong risk for adult cancers. Its safe to say that the children must be exposed to healthy food and lifestyle choices from the very start.
The commonest childhood cancers are Leukemias, brain tumors, lymphomas, Neuroblastoma and Wilms tumors. Unlike Adult cancers the childhood cancers have no associated cause or genetic predisposition and hence screening for them is not available. Only 10% of Childhood cancers are linked to certain genetic conditions. For example children with Down Syndrome are at a higher risk of developing Acute Myeloid Leukemia and can be screened every decade of their life for it. The Maximum cases are diagnosed at the age of 2-6 years which is the crucial period of brain and physical growth, hence they must treated with caution. In a nutshell childhood cancers are unpredictable and they arouse the worst kind of fear in the young parents.
BUT this comes with a silver linings as well because childhood cancers if diagnosed early and adequately treated have a 80% cure rates in High income countries. In low and Middle income countries like ours the cure rates fall to almost 30%. This poor cure rate is due to delayed/inadequate diagnosis, inaccessible/unavailable treatment, abandonment of therapy, death from side effects/treatment toxicity, relapses and financial factors. In a country like ours there is a lack of pediatric cancer specialists and healthcare setups(chemotherapy daycare centres and bone marrow transplant) leading to a gap in diagnosis and management of these cases. The journey to achieve this cure rate to 80% should be near if we can bridge the gaps.
What we can do? A Single National Inititaive to establish chemotherapy and transplant units all across the country should be aimed for. Essential cancer medicines should be made available freely from government setups. Establishing a centralized financial aid which can complete the entire treatment so that we can stop abandonment and relapses in these cases would be a game changer. Private and government joint ventures can bridge this gap at the earliest to bring smiles for our tiny heros.
Dr Neha Singh
M.B.B.S, M.D(Pediatircs), F.I.A.P(Pediatric Hematoncology and BMT)
L.L.B, MBA(Harvard Business School)
